P G Deotale

A Study on Rare Case Report of Unusual Occurrence of Carbuncle due to Delayed Complication of Insulin Injection

A 66 year old male having Diabetes Mellitus of 25 yrs duration well controlled on oral hypoglycaemic drugs. Since one year uncontrolled and persistent hyper glycaemic status with oral hypo glycaemic drugs. Later he has to switch on to insulin injection daily. One day he reported to clinician that description about tiny 2 m.m. firm equal size nodules on his right thigh deep sub cutaneous tissue nodules 4 in number where at previous injection insulin site. Later week he noticed nodules migrated to superficial epidermis surface. His diabetologist planned investigations. By that time within 48 hours nodules turned yellowish colour on the top surface. Therefore his doctor started prophylactic antibiotics that is ciprofloxacin. The yellowish pustules bursts on his own discharging a drop of yellowish colour of thin liquid. So culture and sensitivity was taken and reported as sterile with secondary infection. Same day CRP was done and was negative. Finally one of the remaining residual nodule was subjected to FNAC and histo pathological report shown as foreign body granuloma (as shown in the image). Next 48 hours all four suppurated nodules coalaece together to form dark red unusual carbuncles.